Treatments for ingrown toenails

NewsBot · Feb 2, 2023

Effectiveness of hyaluronic acid in post-surgical cures following partial matricectomies with the phenol/alcohol technique: A randomized clinical trial
Eva Lopezosa-Reca et al
J Tissue Viability. 2023 Jan 28

Background: Post-operative cures with hyaluronic acid (HA) could potentially shorten the period recovery involved in the phenol technique for ingrown toenail. The aim of this study was therefore to compare a standard healing protocol with the experimental one based on hyaluronic acid cream.

Material and methods: 70 patients who had undergone phenol technique surgery for ingrown toenail were divided into two groups - control (n = 35) who received post-operative cures following the standard protocol with povidone iodine gel, and experimental (n = 35) who received cures with HA in the first 3 visits. Bleeding, total healing time, and perceived pain were assessed.

Results: Patients in the control group recovered from the intervention in a total of 26.17 ± 7.75 days, while those in the HA group recovered in a significantly shorter time - 22.42 ± 2.41 days (p = 0.007, effect size 0.653). However, there were no between-group statistical differences in bleeding or perceived pain over the course of the post-surgery visits.

Conclusions: The use of low molecular weight hyaluronic acid is effective in reducing the phenol-technique healing time by 4 days compared with the standard cure. However, no extra effects such as reductions in bleeding or perceived pain can be expected in choosing this healing protocol.
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NewsBot · Feb 19, 2023

Ingrown Toenail Device Therapy with a Cure Rate of 99.5%-Introduction of the Sogawa Method

NewsBot · Mar 20, 2023

A novel modified Winograd surgical tricks and tips with a “bird flap” for the treatment of ingrown toenails☆
Xiuchao Shang et al
Foot and Ankle Surgery; 15 March 2023

Background
The Winograd technique is the most commonly used surgical treatment for ingrown toenails. We describe a novel modified approach, more effective and simpler to perform with a better cosmetic outcome.

Methods
We retrospectively included 45 and 39 patients with 67 and 58 ingrown toenails who underwent our modified Winograd technique and the Winograd technique, respectively, from July 2017 to June 2020, and obtained data after 3, 6, and 12 months of follow-up.

Results
No significant differences in the postoperative time taken to return to regular activities in the modified Winograd and traditional Winograd groups (p=0.103) and regarding the recurrence in both groups (p=0.055) were found. The extent of proximal germinal matrix exposure with the modified Winograd technique was significantly more clearly revealed than in the traditional Winograd method contextually (p<0.05). The postoperative appearance satisfaction rate was significantly higher in the modified Winograd group than in the traditional Winograd group (p=0.029).

Conclusion
The modified Winograd technique is effective in treating ingrown toenails.
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NewsBot · May 16, 2023

Effectiveness of matricectomy with carbon dioxide laser ablation for ingrown toenail in Republic of Korea: a retrospective study
Dong Gyu Kim, Seung Min Nam, Han Gyu Cha, Eun Soo Park
Med Lasers : April 25, 2023.

Background: An ingrown toenail is a common nail disorder that causes pain, discomfort, activity restriction, and inflammation. It may result from improper nail trimming, trauma, tight shoes, infections, hyperhidrosis, obesity, and diabetes. There are various methods to manage ingrown toenails, such as nail avulsion, cryotherapy, chemical cauterization, wedge resection, and laser ablation.
Methods: This retrospective study was performed on 118 patients with an ingrown toenail by a trained plastic surgeon over 15 years (2007-2022). A V-shaped excision was made on the proximal nail fold. The exposed and separated nail matrix underwent a continuous carbon dioxide laser treatment. A nylon suture was used to approximate the edge of the nail fold to the edge of the nail plate.
Results: One hundred and eighteen patients, 58 males and 60 females, with 135 cases of ingrown toenails, were treated. Recurrence was observed in eight toenails (5 males and 3 females). These toenails were re-operated using the same method, with no more recurrences.
Conclusion: Partial matricectomy with carbon dioxide laser ablation is a simple and safe method for ingrown toenails with a high success rate. This procedure destroys the lateral horn of the matrix, avoiding residual nail spicules that may regrow. The procedure has the following advantages over other methods: no tissue damage beyond the cauterized area, no hemorrhage, rapid healing, less postoperative pain and swelling, and reduced recurrence rate. This method can be the treatment of choice for ingrown toenail patients.
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NewsBot · Jun 15, 2023

Conservative treatment options for unguis incarnatus].
Rosien L et al
Source

Unguis incarnatus (ingrown toenail) is a common problem in daily practice. Persons with unguis incarnatus stage two and three are often referred for surgical partial nail excision, however conservative treatment or minimal-invasive alternatives exist. In the latest Dutch guideline for ingrown toenails, there is minimal attention to these alternatives. A podiatrist can do a spiculectomy and places a bilateral orthonyxia (nail brace) or tamponnade afterwards. This treatment option was studied in a prospective cohort study in 88 persons with high risk for wound healing problems and was found to be a safe and effective treatment option. In this clinical lesson we discuss three casus and their treatment options including minimal-invasive treatments. Guidance of the nail growth needs more attention after procedures just like adequate nail clipping advices to prevent for recurrences. Both are not announced in the latest Dutch guideline.
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NewsBot · Jun 16, 2023

A systematic review and meta-analysis of randomised controlled trials on surgical treatments for ingrown toenails part I: recurrence and relief of symptoms
Victoria Exley, Katherine Jones, Grace O’Carroll, Judith Watson & Michael Backhouse
Journal of Foot and Ankle Research volume 16, Article number: 35 (2023)

Background
Ingrown toenails are a common nail pathology. When conservative treatments are ineffective, a surgical approach is often utilised. Despite recent narrative reviews, there is a need for an up-to-date and rigorous systematic review of surgical methods for treating ingrown toenails.

Methods
Five databases (MEDLINE, Embase, CINAHL, Web of Science and CENTRAL) and two registers (Clinicaltrials.gov and ISRCTN) were searched to January 2022 for randomised trials evaluating the effects of a surgical intervention(s) for ingrown toenails with a follow-up of at least 1 month. Two independent reviewers screened records, extracted data, assessed risk of bias and certainty of evidence.

Results
Of 3,928 records identified, 36 (3,756 participants; 62.7% males) surgical interventions were included in the systematic review and 31 studies in the meta-analysis. There was very low quality evidence that using phenol with nail avulsion vs nail avulsion without phenol reduces the risk of recurrence (risk ratio [RR] 0.13 [95% CI 0.06 to 0.27], p < 0.001). No favourable effect was observed between chemical or surgical vs conservative management (0.55 [0.19 to 1.61], p = 0.280; 0.72 [0.33 to 1.56], p = 0.410), chemical or surgical vs other (e.g., CO2 laser, electrocautery) (1.61 [0.88 to 2.95], p = 0.120; 0.58 [0.25 to 1.37], p = 0.220), chemical vs surgical (0.75 [0.46 to 1.21], p = 0.230), surgical vs surgical (0.42 [0.21 to 0.85]), chemical vs chemical (0.19 [0.01 to 3.80], p = 0.280), surgical vs surgical + chemical (3.68 [0.20 to 67.35], p = 0.380), chemical vs surgical + chemical (1.92 [0.06 to 62.30], p = 0.710), local anaesthetic vs local anaesthetic + adrenaline (1.03 [0.22 to 4.86], p = 0.970), chemical timings 30 s vs 60 s (2.00 [0.19 to 21.41]) or antibiotics vs no antibiotics (0.54 [0.12 to 2.52], p = 0.430). Central toenail resection was the only procedure to significantly relieve symptoms (p = 0.001) but data were only available up to 8 weeks post-surgery.

Conclusion
Despite the high number of publications, the quality of research was poor and the conclusions that can be inferred from existing trials is limited. Phenolisation of the nail matrix appears to reduce the risk of recurrence following nail ablation, and with less certainty 1 min appears to be the optimum time for application. Despite this being a widely performed procedure there remains a lack of good quality evidence to guide practice.
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NewsBot · Aug 14, 2023

A Study on the Efficacy of Ω Toenail Correction Treating paronychia
Yang Liu, MD et al
August 12, 2023

To study the clinical effects of Ω toenail correction in the treatment of paronychia. 136 cases of 130 patients during the period from August 2018 to August 2021 were treated with Ω toenail correction according to clinical stages, the clinical therapeutic effects of which were evaluated in terms of the operation time, the time to resume movement, treatment cycle, one-year recurrence rate, and visual analogue scale (VAS) scores before and after treatment. The clinical efficacy was analyzed and compared of Ω toenail correction in treating paronychia of different clinical stages. It has been demonstrated that there was no significant difference in operation time, time to resume movement, treatment cycle and recurrence rate among different stages of paronychia, while there existed the significant difference (p<0.05) in visual analogue scale (VAS) score of resting-state pain before and after correction which stood at 6.43±0.29 points with the after-treatment VAS scores at 1.10±0.22. There is a statistical difference (p<0.05) in VAS score of movement-evoked pain between before and after treatment. The VAS scores of movement-evoked pain stood at 7.55±0.42, which is in contrast with the after- treatment VAS at 1.74±0.93. It has been concluded that Ω toenail correction characterized by easy operation can relieve the pain immediately, which can achieve satisfactory clinical efficacy for treating paronychia of different stages.
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NewsBot · Sep 4, 2023

New, Effective and Minimally Invasive Technique for the Treatment of Ingrown Toenails: Our Application Experiences
Zafer Şenol & Nurhilal Kızıltoprak
Indian Journal of Surgery (2023)

Ingrown nail is a serious medical problem and the correct approach for its treatment is still controversial in the existing literature. In this study, we presented the results of our application experiences on our new developed technique for the treatment of ingrown toenails. The study is a prospective clinical quasi experimental study for treatment. This study included 147 patients who applied to SBU Sultan 2. Abdülhamid Han Training and Research Hospital, General Surgery Clinic with the complaint of ingrown toenails. The duration of the study covers October 2018 to March 2022 and the 6-month follow-up period for each patient. All the patients were treated with this minimally invasive technique. In this technique, a piece cut in the form of a half-groove, 3–4 cm long, obtained from the tube part of the intravenous drip set plastic, is placed between the dermis and the nail in a sandwich model and fixed to the nail with the suture technique. According to the results of the study, overall recurrence rate was low at 9.5% (14 patients). The follow-up results by the end of six months demonstrated that the technique is very effective for the treatment of ingrown toenails that 94.5% of the patients had no complaints. Our application experiences with our new minimally invasive technique for treating ingrown toenails, presented in this study, have shown that this technique is quite effective. The main advantages of the technique are the preservation of the anatomy and function of the nail, high patient satisfaction, less pain, rapid recovery, low recurrence rate, and ensuring patients a quick return to their daily activities or work life.
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NewsBot · Sep 8, 2023

A systematic review and meta-analysis of randomised controlled trials of surgical treatments for ingrown toenails part II: healing time, post-operative complications, pain, and participant satisfaction
Victoria Exley, Katherine Jones, Grace O’Carroll, Judith Watson & Michael Backhouse
Journal of Foot and Ankle Research volume 16, Article number: 55 (2023)

Background
When performing nail surgery, clinicians must choose from a multitude of procedures and variations within each procedure. Much has been published to guide this decision making, but there are a lack of up to date robust systematic reviews to assess the totality of this evidence.

Methods
Five databases (MEDLINE, Embase, CINAHL, Web of Science and CENTRAL) and two registers (Clinicaltrials.gov and ISRCTN) were searched to January 2022 for randomised trials evaluating the effects of a surgical intervention(s) for ingrown toenails. Two independent reviewers screened records, extracted data, assessed risk of bias and certainty of evidence. Data on co-primary outcomes of symptom relief and symptomatic regrowth were presented in our first paper. This paper presents data for the secondary outcomes and further discussion.

Results
Of 3,928 records identified, 36 randomised trials were included in the systematic review. Healing time appears to be reduced with shorter application of phenol. A reduced healing time was also apparent was with the addition of curettage, although this may also increase the risk of post-operative bleeding and pain. Post operative bleeding was also reportedly lower in people who received local anaesthetic with epinephrine but no tourniquet. Use of phenol with nail bed excision may decrease the risk of infection. Lower pain scores were reported when using partial matrixectomy and surgical interventions with phenol. Shorter duration of pain was reported with phenolisation and wedge resection. Participant satisfaction was high overall.

Conclusion
This second paper reports secondary outcomes from a robust systematic review of randomised trials on surgical treatment of ingrown toenails. Despite the large volume of clinical trials conducted on the topic, few clinical conclusions can be drawn due to the poor quality of these studies. Further high-quality clinical trials are needed to answer fundamental questions in the surgical treatment of ingrown toenails.
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NewsBot · Sep 28, 2023

An Initial Study of Ingrown Toenail Removal Simulation in Virtual Reality with Bimanual Haptic Feedback for Podiatric Surgical Training
Jason Abounader; Kwangtaek Kim; Bryan D. Caldwell; Mark A. Hardy
Source

An initial study was conducted to identify the strengths and weaknesses of an ingrown toenail removal simulation we developed in collaboration with the Kent State College of Podiatric Medicine. In this paper, we describe the methods used in 3D modeling and haptic rendering development of the simulation with virtual reality and bimanual haptic feedback. The simulation utilizes dual Geomagic Touch Devices. These stylus-based devices sense force magnitude and movement responding with motor resistance. Multiple tasks of ingrown toenail surgery were simulated including anesthesia, elevation, and cutting. An evaluation experiment was conducted and data was recorded through a post-simulation questionnaire accompanied by a NASA Task Load Index inquiry. The results demonstrate that the developed system is acceptable for training medical students who need to practice podiatric surgery procedures.
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NewsBot · Oct 10, 2023

The use of silver nitrate (AgNO3) as a caustic agent for the treatment of hypergranulation tissue affecting in-growing toenails: A scoping review.
Ravenscroft R, Reilly I.
J Int Foot Ankle [Internet]. 2023 Sep. 1

Silver compounds have been used in medicine to treat infections, open wounds, and chronic ulcers. Silver nitrate is used as a caustic, antiseptic, haemostatic and astringent agent. Using high-strength silver nitrate to treat the hypergranulation tissue complicating ingrown toenails is a customary practice by podiatrists in the United Kingdom. This study aims to identify what primary literature is available concerning the use of silver nitrate in this scenario, as anecdotal evidence suggests that its efficacy is limited. A scoping review of the literature was performed. The senior author searched electronic databases for primary studies and completed the independent screening process. The search identified 325 studies. After the rejection of those that were not relevant, a full-text review of 22 studies was performed. 21 studies were rejected as irrelevant, and one study was included. The second author then performed a free text search on Google and Google Scholar and found two further articles. In conclusion, this review found very little evidence to support the use of silver nitrate for treating the hypergranulation tissue affecting ingrown toenails.
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NewsBot · Oct 30, 2023

Use of phenol in ingrown nail surgery
Source

Ingrown nails can be troublesome and in case of pronounced problems, you sometimes need to remove part of the nail under local anesthesia. To prevent the removed part of the nail from growing back and again causing problems, phenol is applied to the nail layer, which causes it to regress. Phenol is highly corrosive and toxic. Reading time approx. 6 minutes Published: June 16, 2023 Publication type: SBU Enquiry
Question
What scientific studies have been published regarding the positive and negative effects of the use of phenol in ingrown nail surgery?

Method
A systematic literature search was performed using the following databases: Medline and SCOPUS.

Two authors independently assessed the abstracts of all identified studies.
Risk of bias in relevant systematic reviews was assessed using an assessment tool based on AMSTAR.

Identified literature
In two relevant systematic reviews, the risk of bias was considered to be high, therefore the results and conclusions are not reported [1, 2]. In addition, five relevant primary studies were identified [3-7]. Primary studies are not assessed for risk for bias.
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NewsBot · Jan 8, 2024

Pulmonary edema: A complication of post-complete ingrown toenail excision. A case report
Aljonaieh, Khalid Ibrahim; Aldakhil, Sadal
Saudi Journal of Anesthesia 18(1) 131-133, Jan–Mar 2024. | DOI: 10.4103/sja.sja_536_23

A sympathetic crashing pulmonary edema (SCAPE) is an emergency medical situation necessitating early recognition and treatment. We present a case of a 15-years old male who underwent a toenail excision of his left big toe and who developed SCAPE postoperatively. The low incidence of SCAPE intraoperatively makes it challenging for anesthesiologists to diagnose it. It occurs unexpectedly and precipitously, and it may increase the risks of morbidity and mortality if it is not treated promptly. Our aim is to raise awareness of how to abruptly manage such cases.
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NewsBot · Jan 16, 2024

Surgical interventions for ingrown toenail
Shan Huang et al
Foot Ankle Surg. 2023 Dec 26:S1268-7731(23)00236-9

Background: Paronychia is a prevalent clinical disease affecting the soft tissue surrounding the nails. Most cases of toenail paronychia are commonly associated with ingrown toenails. While conservative treatment is effective for mild cases of ingrown toenails, surgical intervention becomes necessary for moderate to severe cases, particularly when granulomas form.

Objective: To provide a systematic understanding of these classic and modified procedures for surgeons to select the appropriate surgical interventions for patients suffering from moderate to severe ingrown toenails and discuss this technology's advantages and limitations for dermatologic surgery.

Methods: A literature search was performed using PubMed/MEDLINE and Google Scholar databases. Studies discussing surgical intervention for ingrown toenails were included. Moreover, the surgical steps were meticulously depicted by detailed schematic diagrams.

Results: These surgical techniques can be divided into three categories: matrix resection, debulking of periungual soft tissues, and the rotational flap technique. Each approach possesses distinct advantages and limitations.

Conclusion: For moderate to severe cases, surgical interventions may exhibit superior outcomes, faster recovery times, and lower recurrence rates. The surgeon must possess a comprehensive understanding and proficient skillset in various surgical techniques for ingrown toenails.
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NewsBot · Jan 18, 2024

Surgical Treatment of Ingrown Toenails Part 1: Recurrence and Relief

NewsBot · Feb 11, 2024

Surgical Treatment of Ingrown Toenails Part II: Post-operative Data

NewsBot · Feb 21, 2024

Ingrown Toenails: A Survey Among Dermatologists on Current Treatments
Corinna Dressler et al
Dermatol Surg. 2024 Feb 1

Background: To date, there is no formal consensus on how to treat ingrown toenails. Despite the risk of causing irreparable damage to the nail, highly invasive procedures are still common. Less-invasive, matrix-directed techniques with shorter downtime and high cure rates exist, but, perhaps because of a lack of awareness, appear not to have been universally adopted.

Objective: The authors' study sought to generate data on common practices in the treatment of ingrown toenails.

Materials and methods: The authors developed and conducted an online survey to ask dermatologists/dermatosurgeons how they would proceed in 9 different cases of ingrown toenails based on photographs.

Results: The authors received 154 replies. Nonsurgical interventions, including advice on nail care/foot baths/ointments/wraps/padding, were always the most frequently chosen option. Removal of the lateral nail plate followed by chemical partial matricectomy (phenolization) was the most or second-most frequently chosen surgical intervention. The answers were highly heterogeneous, and there was no unanimity based on morphology alone.

Conclusion: Except for a preference for nonsurgical interventions, the authors could not identify any clear treatment standards. The heterogeneity of treatment approaches suggests the need for a guideline.
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NewsBot · Apr 16, 2024

Surgical Strategies for Ingrown Toenails: A Comprehensive Review of Techniques, Outcomes, and Advancements
Hassan et al.
Cureus 16(1): e52501. DOI 10.7759/cureus.52501

Ingrown toenail (IGTN), known as onychocryptosis or unguis incarnatus, is a painful condition affecting the big toe, with symptoms including pain, inflammation, and infection. This review explores surgical options for IGTN, categorized into altering the nail plate or diminishing periungual tissues. Conservative treatments alleviate early-stage symptoms, while surgical interventions are reserved for severe cases. Various surgical techniques are discussed, such as the Winograd technique, Vandenbos procedure, chemical matricectomy, radiofrequency ablation, bipolar diathermy, carbon dioxide laser ablation, Zadik’s procedure, Howard-Dubois procedure, Super U procedure, Noël’s procedure, knot technique, and toenail paronychium flap. The choice of procedure depends on the severity and recurrence of IGTN.
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NewsBot · Jun 6, 2024

A survey of the treatment and management of ingrown toenails by UK podiatrists: A cross-sectional survey
Victoria Exley et al
J Foot Ankle Res. 2024 Jun;17(2)

Background: Ingrown toenails are a common pathology. Although a range of conservative and surgical measures are widely used for this condition, little is known about their use in practice. This study explored current practice relating to the treatment or management of ingrown toenails by podiatrists in the UK.

Methods: A cross-sectional online survey (Qualtrics, Provo, UT, USA) conducted between March to June 2020 was distributed to practicing podiatrists treating or managing ingrown toenails in the UK.

Results: A total of 396 practicing podiatrists responded (60.1% based in the private sector). The majority (88.6%) performed nail surgery most commonly (54.3%) less than five a month. Nearly all (95%) only performed nail avulsion with or without chemical matrixectomy, universally using phenol (97.2%). Application time and number of applications varied but was most commonly applied three times (61.5%) for a total of 3 minutes (75%). Aftercare varied considerably between public and private sectors, with public sectors offering fewer follow-up appointments.

Conclusions: Although there is a variation in clinical practice throughout the treatment pathway, almost all respondents offered nail avulsion with phenol matrixectomy, whereas very few provided incisional nail surgery. This data provides the most comprehensive description of how UK podiatrists conduct nail surgery for onychocryptosis.
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NewsBot · Jul 7, 2024

Onychocryptosis: a retrospective study of clinical aspects, inflammation treatment and pain management using Ozoile as a hydrogel and cream formulation
Vincenzo Francavilla et al
Eur J Transl Myol. 2024 Jun 26;34(2).

Ingrown toenails account for roughly 20% of all foot problems in primary care. It is most common in young men, with nail care habits and footwear being major contributors. Onychocryptosis is typically caused by self-treatment attempts to cure the condition in its early stages. Its clinical features are frequently confused with other osseous and soft tissue abnormalities. The goal of this study was to provide perspectives on the management of pain and inflammation in Onychocryptosis using an Ozoile-based hydrogel formulation in a semi-occlusive bandage for 14 days, while incorporating natural pharmacological solutions into established protocols. The primary outcomes measured were pain reduction on NRS and stadiation according to the Al Kline Classification. The reduction was statistically significant, with a mean decrease in VAS score from 10 to 4 (p < 0.05), and Al Kline classification decreased by an average of 1.6 stages. 42% of patients recovered within the first 15 days of treatment, and 93% by the end of the scheduled treatment.
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NewsBot · Jul 30, 2024

Senior Podiatrists in Solo Practice are High Performers of Nail Excisions
Gabrielle M Rivin et al
J Am Podiatr Med Assoc. 2024 May-Jun;114(3):22-063

Background: Nail excisions are indicated for onychocryptosis and nail spicules. They are technically demanding and require a refined skill set. We aimed to characterize practice patterns of US providers performing nail excisions.

Methods: We conducted a retrospective analysis of Medicare provider use and payment data, part D, for all claims of partial or complete nail/nail matrix excision with/without nail plate removal/destruction (current procedural terminology code 11750). High performers were defined as providers performing annual nail excisions 2 standard deviations above the mean. We analyzed demographic risk factors for nail excision high performers, including practice location, years of experience, household median income, practice type, and provider gender. Statistical analysis was conducted in SAS v9.4, with values of P < .05 considered statistically significant.

Results: Providers (n = 32,279) and high performers (n = 942) performed mean 34.7 and 173 nail excisions annually. Unsurprisingly, podiatrists constituted 99.7% of all nail excision performers. Providers in the South versus Midwest and Northeast were more often nail excision high performers (odds ratio [OR], 1.95; P < .0001, and OR, 1.46; P < .0001). Solo versus group practitioners were more likely, respectively, to be nail excision high performers (OR, 2.15; P < .0001). With linear regression analysis, for every 10-year increase in years of provider experience, there was an increase of 1.2 nail excisions annually per provider (P < .0001). For every $100,000 increase in household median income of practice location, there was a decrease of 9.9 nail excisions annually per provider.

Conclusions: Southern podiatrists, podiatrists with more years of experience, solo practitioners, and those practicing in regions with lower household median incomes were more likely to perform higher numbers of nail excisions. Identifying performance trends among podiatrists can help podiatrists understand how their performance of nail excisions compares to other podiatrists across the country.
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NewsBot · Sep 27, 2024

A comparative study on the efficacy between omega toenail correction and winograd procedure for stage II-III paronychia
Yang Liu, MD et al
Source

The objective of this study is to conduct a prospective trial comparing the therapeutic efficacy of Omega toenail correction and the Winograd procedure in treating stage II-III paronychia. From August 2018 to August 2023, ninety cases from eighty-three patients were randomly divided into two groups, one receiving Omega toenail correction (experimental group) and the other receiving the Winograd procedure (control group). The clinical therapeutic effects of both treatments were evaluated based on time to resume movement, treatment cycle, one-year recurrence rate, and visual analogue scale (VAS) scores before and after treatment. The clinical efficacy was compared between Omega toenail correction and Winograd procedure treating paronychia of stage Ⅱ-Ⅲ. It has been demonstrated that the time to resume movement in the experimental group is obviously shorter than that in the control group (P = 0.024), while the treatment cycle is longer (P = 0.009) with no significant difference (P = 0.734) in the aspect of one-year recurrence rate. However, the VAS after the correction in the experimental group is significantly lower than that in the control group (P = 0.019). It has been suggested that Omega toenail correction characterized by easy operation, sure efficacy and lower recurrence rate can be widely applied in clinic work.
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NewsBot · Oct 18, 2024

Treatment of ingrown toe nail by homoeopathic
approach
Dr. Amit Nayak et al
International Journal of Homoeopathic Sciences 2024; 8(1): 320-324

In-grown toenail is an irritating lesion often encountered in clinical practice. It is largely a lesion of
tight-fitting shoes, trauma in toes or poorly trimmed toenails among many other risk factors identified
epidemiologically. Though not life threatening, in-grown toenail affects the quality of life by causing
pain, limiting comfort and activity among those affected. Treatment may be conservative in the early
stages but when recurrent or seen in late-stage, surgery offers a better and lasting outcome. In
homoeopathy this condition can easily be treated without any surgical intervention, just by stimulating
the body’s natural restorative process.
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NewsBot · Oct 24, 2024

Wedge Resection and Nail Groove Reconstruction With
Hanging Thread Knot in the Treatment of Onychocryptosis
Yonghong Hao et al
Source

Background: Onychocryptosis is characterized by the nail plate penetrating the lateral nail fold, resulting in varying degrees of
infection and deformity. Standardized treatment protocols for onychocryptosis, particularly in Stages IIb, III, and IV, have not
been universally established, highlighting the urgent need for the development of effective interventions.
Objective: To evaluate the effectiveness and safety of wedge resection and nail groove reconstruction using the hanging thread
knot for the treatment of onychocryptosis.
Methods: At our hospital, a total of 155 patients with onychocryptosis in Stages IIb, III, and IV underwent treatment. Wedge
resection and nail groove reconstruction with the hanging thread knot were applied based on the severity of deformity and infection for treating onychocryptosis. All patients received perioperative systematic and topical anti-infective treatments. Follow-ups
conducted over a period of 2–6months assessed postoperative rehabilitation and complications.
Results: The cure rate reached 95%, with a low recurrence rate of 5%. Recurrence, observed in eight patients, was attributed to
various causes: three due to improper trimming, three related to trauma, one associated with obesity, and one due to incomplete
matrix resection. All eight patients achieved complete recovery through health guidance and secondary surgery. Satisfaction
results were reported during the 2–6months follow-up period. Although 10 patients experienced secondary local infections, all
achieved complete recovery following active treatment.
Conclusion: Wedge resection and nail groove reconstruction with the hanging thread knot prove to be an effective and safe
method for treating onychocryptosis.
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NewsBot · Oct 24, 2024

Ingrown Toenail Management Across Mental Health and Other Health Facilities in Nigeria: A Review of Anesthetic and Surgical Management
David Chibututu Nwobu et al
J. Adv. Med. Med. Res., vol. 36, no. 5, pp. 217-223, 2024; Article no.JAMMR.115504

Background: The management of ingrown toenails in Nigeria is notably underdeveloped, posing potential challenges for patients in mental health facilities and beyond. Addressing this issue requires an interdisciplinary approach and collaboration with other healthcare professionals. Furthermore, there is an important need for a comprehensive review of the treatment guidelines for the anesthetic and surgical techniques utilized in its treatment to improve the quality of patient care. Methods: We employed a structured narrative approach to identify and review available articles on ingrown toenail management in mental health and other health facilities in Nigeria. We aimed to evaluate the anesthetic and surgical techniques utilized in managing these patients. Results: No documented treatment for ingrown toenails was identified among patients in mental health facilities across Nigeria. While various surgical techniques are employed for management in other health facilities, the specific anesthesia techniques utilized are unclear. Conclusions: A unified management protocol and guideline for ingrown toenails and developing podiatry training in Nigeria are imperative. Developing and implementing an effective treatment protocol improves the quality of care and widens coverage for all patients. In addition, establishing podiatry training across educational facilities could bridge this gap in ensuring optimal care for these patient populations.
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NewsBot · Nov 1, 2024

A customized syringe for separating ingrown toe nail from the gutter
Muhammed Mukhtar , Nadia Mukhtar
J Cutan Aesthet Surg. 2024 Jul-Sep;17(3):259-261.

Ingrown toenails is a painful foot problem seen in primary care among young men. To provide immediate pain relief, some types of splints are placed in the gutter to separate it from the ingrown lateral nail. There are time-consuming and effort-intensive procedures that use available nail separators and elevators to separate the nail plate. Here, the hub of the syringe is cut obliquely to create a beveled or slant edge to create a custom nail separator which is a useful device for the easy and less painful separation of the ingrown nail plate from its gutter, which is an important stage of nail splinting.
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NewsBot · Nov 2, 2024

Steri-Strip Sling Technique – A Simple Procedure for the Management of Ingrown Toenails – A Prospective Study
Ranjan, Eeshaan; Arora, Sandeep1; Sharma, Neha2; Tripathy, Durga M.3; Neema, Shekhar4; Srivastava, Shailendra; Agarwal, Reetu
Indian Journal of Dermatology 69(5) 391-395, Sep–Oct 2024. | DOI: 10.4103/ijd.ijd_1174_23

Background:

Ingrown toenail is a nail disorder that commonly affects great toenails. Surgical modalities are commonly used as first-line treatment. A conservative approach is preferable as surgical procedures lead to pain and affect routine activities. Our aim is to study the efficacy of a new conservative technique using steri-stripTM for the treatment of mild to moderate ingrown toenails as an outpatient procedure.
Methods:

Fifty patients presenting with stage 1–2 ingrown toenails were treated with the ‘steri-strip sling technique’. Steri-stripTM is inserted between the disto-lateral edge of the nail plate and nail fold and secured with an elastic bandage. The dressing is kept till the nail edge grows over the nail fold and stops penetrating the skin. Patients were reviewed every week for a month after the treatment and monthly thereafter. The final result was assessed at 6 months. The success of treatment was assessed clinically and by patient satisfaction levels.
Results:

Fifty patients were treated and followed up. Immediately after the procedure, all patients reported significant relief in pain. After 6 months, 46 out of 50 patients were satisfied with the treatment and showed no recurrence. No complications were reported.
Conclusion:

The ‘Steri-stripTM sling technique’ is a simple and effective outpatient procedure for the management of mild to moderate ingrown toenails.
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NewsBot · Nov 14, 2024

Effectiveness of Local Glucocorticoid Infiltration Versus Traditional Gauze Bandaging for the Treatment of Onychocryptosis: A Randomized Controlled Trial
María Teresa García-Martínez et al
Healthcare (Basel). 2024 Oct 27

Background/objectives: Local intralesional corticosteroid injections into the periungual fold are used to treat patients with onychocryptosis, but their short- or medium-term effects are unknown. The goal was to compare the efficacy of this treatment in stages IIa, IIb, and III of the condition with a common conservative method such as gauze bandaging.

Methods: A two-arm randomized trial with 40 patients with stage IIa, IIb, and III onychocryptosis equally assigned into two treatment groups-control (spiculotomy and application of gauze bandaging) and experimental group (spiculotomy and infiltration of corticosteroid)-was performed. Anthropometric data, initial clinical status, pain, and inflammatory measures were collected before and at least one month after the intervention.

Results: Pain reduction was higher in the experimental group (5.5 vs. 4.8 points) but with no significant differences (p = 0.306).Corticosteroids significantly reduced inflammation over gauze bandaging (1.9 vs. 1) with significant differences between them (p = 0.029).

Conclusions: Corticosteroid infiltration was more effective than gauze bandaging application in reducing inflammation in patients with onychocryptosis, with similar effects on pain. These findings support the clinical importance of corticosteroid treatment for this condition, although a single infiltration may not be sufficient to prevent relapses.
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NewsBot · Dec 6, 2024 at 5:03 AM

A new treatment for ingrown toenail with CO2 laser: a retrospective study,
Ganggang Li, Xuejing Tan, Yuxin Hui, Xiaoqiang Li, Dan Han, Yanli Yuan & Huiqun Ma
Journal of Dermatological Treatment, 35:1, 2434698

Background: here are various surgical treatments on ingrown toenails. owever, the treatment
without matricectomy, damaging the nail and not operating on the nail bed could be better.
Objective: o present a new treatment for ingrown toenail that completely preserve the nail and nail
matrix.
Methods: 52 surgical procedures were performed on 47patients with ingrown toenail who applied to
ermatology epartment from May 14th, 2021 to March 12th, 2023 were enrolled. A certain volume
of soft tissue surrounding the lesion was ablated under local anesthesia.
Results: 52 surgical procedures were performed on 47patients. All lesions’ results were excellent except
3 with relapse (the cure rate is 94.23%). hese cases healed after retreatment. uring the minimum of
1year follow-up, the cosmetic effect was remarkable with normal appearance and function. he mean
operative time was 9.83±2.24min. here were no complications was observed. he mean time for
patients returning to walk was1.36±0.49days.
Conclusion: his study demonstrates that ingrown toenail can be surgically treated without
matricectomy and preserved the nail. All necrotic tissue and certain volume of soft tissue surrounding
the lesion should be ablated to decompress the nail and reduce inflammation.
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Treatments for ingrown toenails

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Treatments for ingrown toenails

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